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      Hipoalbuminemia como predictor de mortalidad de sepsis por COVID-19. Hospital II Chocope, 2020 Translated title: Hypoalbuminemia and mortality of sepsis from covid-19 in a Hospital in Chocope, Perú,2020

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          Abstract

          RESUMEN Introducción: Se realizó una investigación de tipo correlacional evaluando a 145 pacientes con sepsis por COVID-19. Objetivos: Determinar si la hipoalbuminemia es predictor de mortalidad de sepsis por COVID-19 e identificar el valor sérico de albumina más frecuentemente relacionado con la letalidad. Métodos: Se incluyeron a pacientes mayores o igual de 18 años atendidos en el Hospital II Chocope durante mayo a agosto del 2020. Se excluyeron a pacientes con patologías oncológicas, e historias clínicas incompletas. La técnica empleada es la de análisis documental, mediante la revisión de historias clínicas. Resultados: Hubo asociación estadísticamente significativa entre la hipoalbuminemia y mortalidad (p=0,014), los pacientes con hipoalbuminemia tuvieron 3 veces más riesgo de fallecer. (OR=3,97 IC al 95% de 1,24-12,74). Así mismo, la sensibilidad y especificidad más alta de la prueba fue cuando el punto de corte de la hipoalbuminemia estuvo en 1,38 g/dL. Finalmente, la hipertensión arterial es la enfermedad asociada más frecuente. Conclusiones: La hipoalbuminemia puede ser un predictor de mortalidad en pacientes con sepsis por COVID-19 en el Hospital de Chocope por tener asociación estadísticamente significativa, con tres veces más riesgo de fallecer. La sensibilidad y especificidad más alta se obtuvo con un punto de corte de albuminemia de 1,38 g/dL. La comorbilidad más frecuente en pacientes con sepsis por COVID-19 que fallecieron fue la hipertensión arterial.

          Translated abstract

          ABSTRACT Introduction: A correlational type investigation was carried out evaluating 145 patients with COVID-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p=0.014), patients with hypoalbuminemia had 3 times the risk of dying. (OR=3.97 95% CI of 1,24-12,74). Likewise, the highest sensitivity and specificity of the test was when the cut-off point for hypoalbuminemia was 1.38 g / dl. Finally, the most frequent comorbidity was arterial hypertension. Conclusions: Hypoalbuminemia can be a predictor of mortality in patients with sepsis due to COVID-19 at the Hospital de Chocope because it has a statistically significant association, with three times the risk of death. The highest sensitivity and specificity was obtained with an albuminemia cutoff of 1.38 g / dL. The most frequent comorbidity in patients with sepsis due to COVID-19 who died was arterial hypertension.

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          Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

          The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The performance of clinical criteria for this sepsis definition is unknown.
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            Low Albumin Levels Are Associated with Mortality Risk in Hospitalized Patients.

            The aim of this study was to investigate the association of albumin levels on admission and change in levels during hospitalization with hospitalization outcomes.
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              Hypoalbuminemia Is a Strong Predictor of 30-Day All-Cause Mortality in Acutely Admitted Medical Patients: A Prospective, Observational, Cohort Study

              Objective Emergency patients with hypoalbuminemia are known to have increased mortality. No previous studies have, however, assessed the predictive value of low albumin on mortality in unselected acutely admitted medical patients. We aimed at assessing the predictive power of hypoalbuminemia on 30-day all-cause mortality in a cohort of acutely admitted medical patients. Methods We included all acutely admitted adult medical patients from the medical admission unit at a regional teaching hospital in Denmark. Data on mortality was extracted from the Danish Civil Register to ensure complete follow-up. Patients were divided into three groups according to their plasma albumin levels (0–34, 35–44 and ≥45 g/L) and mortality was identified for each group using Kaplan-Meier survival plot. Discriminatory power (ability to discriminate patients at increased risk of mortality) and calibration (precision of predictions) for hypoalbuminemia was determined. Results We included 5,894 patients and albumin was available in 5,451 (92.5%). A total of 332 (5.6%) patients died within 30 days of admission. Median plasma albumin was 40 g/L (IQR 37–43). Crude 30-day mortality in patients with low albumin was 16.3% compared to 4.3% among patients with normal albumin (p<0.0001). Patients with low albumin were older and admitted for a longer period of time than patients with a normal albumin, while patients with high albumin had a lower 30-day mortality, were younger and were admitted for a shorter period. Multivariable logistic regression analyses confirmed the association of hypoalbuminemia with mortality (OR: 1.95 (95% CI: 1.31–2.90)). Discriminatory power was good (AUROC 0.73 (95% CI, 0.70–0.77)) and calibration acceptable. Conclusion We found hypoalbuminemia to be associated with 30-day all-cause mortality in acutely admitted medical patients. Used as predictive tool for mortality, plasma albumin had acceptable discriminatory power and good calibration.
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                Author and article information

                Journal
                rfmh
                Revista de la Facultad de Medicina Humana
                Rev. Fac. Med. Hum.
                Universidad Ricardo Palma (URP) (Lima, , Peru )
                1814-5469
                2308-0531
                January 2021
                : 21
                : 1
                : 12-18
                Affiliations
                [1] Trujillo orgnameUniversidad César Vallejo Peru
                Article
                S2308-05312021000100012 S2308-0531(21)02100100012
                10.25176/rfmh.v21i1.3437
                f14c5bd3-b3ea-4245-b0fc-930efabad7e4

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 01 December 2020
                : 06 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 7
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                SciELO Peru

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                Artículo original

                Mortalidad,Sepsis,Hipoalbuminemia,COVID-19. (Source: MeSH NLM),Mortality,Hypoalbuminemia,COVID-19. (Fuente: Decs BIREME)

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